A Promising Milestone in Coverage for Obesity Treatments

Letter from the Executive Director

TOS eNews - April 2, 2014

Dear Colleagues,

I’m pleased to share with you some fantastic news coming out of Washington this week regarding Federal Employees Health Benefits coverage of weight-loss medications. The Office of Personnel Management (OPM), responsible for health insurance coverage for Federal Employees, acted in support of health coverage for FDA-approved weight-loss treatments - setting the stage for other health plans to follow. This ruling stating that obesity exclusions are no longer permissible in health plans for federal employees is a much-needed step toward improving access to medical interventions for many people with obesity.

In the March 20th letter to all FEHB carriers, John O’Brien, the Director of Healthcare and Insurance at OPM, agrees that while “diet and exercise are the preferred methods for losing weight, …drug therapy can assist [those] who do not achieve weight loss through diet and exercise alone.”

In the letter, O’Brien provides further clarification:

"It has come to our attention that many FEHB carriers exclude coverage of weight-loss medications. Accordingly, we want to clarify that excluding weight loss drugs from FEHB coverage on the basis that obesity is a "lifestyle" condition and not a medical one or that obesity treatment is "cosmetic"- is not permissible. In addition, there is no prohibition for carriers to extend coverage to this class of prescription drugs, provided that appropriate safeguards are implemented concurrently to ensure safe and effective use."

Clearly, OPM understands that treating obesity is a medical necessity. We call on all public and private health plans to follow suit and embrace coverage of evidence-based obesity treatment avenues, such as intensive behavioral therapy, pharmacotherapy and bariatric surgery so that those affected can access to the full continuum of care for this complex and chronic disease.

While this move by OPM certainly shows progress, this is just the beginning. The Obesity Society will continue to work alongside our partners in the Obesity Care Continuum to improve health insurance coverage of these proven obesity treatments. And we hope you’ll join us by volunteering your time to come to Washington, or simply by sending a letter to your member of Congress in support of obesity treatments. Stay tuned for further opportunities to get involved!

Sincerely,

Francesca Dea

Executive Director, The Obesity Society

(Please note: External Links are provided as a courtesy. The Obesity Society is not responsible for the content on sites accessed through external links.)